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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) GENTAMICIN GENTAMICIN 10X2ML B 12.48 1.25 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 081202 AMINOGLYCOSIDES 2022-04-01 2022-05-31 IV/IM 6 ANTI-INFECTIVE AGENTS
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) GENTAMICIN GENTAMICIN 10X2ML B 19.27 1.93 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 081202 AMINOGLYCOSIDES 2022-06-01 2024-03-31 Price Change IV/IM 6 ANTI-INFECTIVE AGENTS 2022-05-31
41 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM) (B) GENTAMICIN GENTAMICIN 10X2ML B 14.9 1.4896 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 081202 AMINOGLYCOSIDES 2024-04-01 2026-03-31 IV/IM 0 AMINOGLYCOSIDES
42 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM) GENTAMICIN GENTAMICIN 10X2ML B 10.87 1.09 AMPG 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 081202 AMINOGLYCOSIDES 2026-04-01 IV/IM 0 AMINOGLYCOSIDES
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI GENTAMICIN GENTASHIP 10X2ML B 5.41 0.54 INJECTION 0 AMP FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 081202 AMINOGLYCOSIDES 2022-04-01 2022-07-11 IV/IM 6 ANTI-INFECTIVE AGENTS
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI GENTAMICIN GENTASHIP 10X2ML B 6.74 0.67 INJECTION 0 AMP FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 081202 AMINOGLYCOSIDES 2022-07-12 2024-03-31 Price Change IV/IM 6 ANTI-INFECTIVE AGENTS 2022-07-11
42 0321BD GENTACURE 40MG/ML IV/IM INJ (JLP) GENTAMICIN GENTAMICIN GENTACURE 100X2ML B 78.83 0.79 VIAL 0 VIAL JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 081202 AMINOGLYCOSIDES 2026-04-01 IV/IM 0 AMINOGLYCOSIDES
40 03248 GENOPTIC 0.3% EYE DR (ASL/PHA) GENTAMICIN GENTAMICIN GENOPTIC 5ML BQ 4.08 4.08 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 03248 GENOPTIC 0.3% EYE DR (ASL) GENTAMICIN GENTAMICIN GENOPTIC 5ML BQ 7.34 7.3395 BOTT 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT ANTIBACTERIALS
42 03248 GENOPTIC 0.3% EYE DR (ASL) GENTAMICIN GENTAMICIN GENOPTIC 5ML B 6.63 6.63 BOTT 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2026-04-01 OPHTHALMIC 0 EENT ANTIBACTERIALS
40 03267 GENTAMICIN 0.3% EYE OINT (AKI/AHI) GENTAMICIN GENTAMICIN 3.5G C 156.87 156.87 EYE OINTMENT 0 TUBE AKI AKORN INC. AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS